Relationship Between Screen Time, Core Executive Functions, and Vocabulary in Preschool: The Role of Parental Mediations and Beliefs

Objective: To investigate the current status of screen time in children with ASD, its correlation with autistic symptoms and developmental quotient (DQ), and the factors affecting screen time.Method: One hundred ninety-three Chinese children with ASD were recruited. We collected the demographic and screen time data using a questionnaire. The ASD core symptoms and developmental quotient (DQ) were measured by the Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), Autism Diagnostic Observation Schedule-Second Edition (ADOS-2), Griffiths Development Scales-Chinese Language Edition (GDS-C), and Chinese Children's Parent-Child Relationship Questionnaire (CPCIS). Then, we analyzed the correlations between the screen time of children with ASD and the ABC, CARS, ADOS, GDS-C DQs, and CPCIS scores. Linear regression was used to analyze the risk factors that affect screen time.Results: The children's average daily screen time was 2.64 ± 2.24 h. Forty eight percent children were exposed to two or more types of electronic devices. Their favorite activity of screen time was watching cartoons. Only 34% children spent screen time accompanied by parents and with communication. 50.26% children had no screen time before sleeping. The screen time of children with ASD had a negative correlation with the GDS-C CQ (r = −0.234, P = 0.001) and the CPCIS score (r = −0.180, P = 0.012) and a positive correlation with the CARS score (r = 0.192, P = 0.009). A low father's education level (P = 0.010), less restriction of the child's screen time by the guardian (P = 0.001), greater caregiver screen time (P < 0.001), the use of the screen as a tool for child rearing (P = 0.001), and the child's ownership of independent electronic equipment (P = 0.027) are risk factors for long screen time in children with ASD.Conclusion: The screen time of children with ASD in China is higher than the recommended standard, and the current situation is serious. The screen time of ASD children is related to their autism symptoms, DQ and parent-child interaction. Low paternal education levels, less restriction of children's screen time by guardians, greater guardian screen time, the use of screens in child rearing, and children's ownership of independent electronic equipment can lead to an increase in children's screen time. These findings may have implications for family intervention strategies.

Associations among screen time, sleep, mental health and cognitive functioning in school-aged children during the COVID-19 pandemic, November 2020 through to August 2022

Children’s executive function during the COVID-19 pandemic in Argentina: Associations with home literacy, reading, and screen times

The good, the bad and the ugly of children´s screen time during the COVID-19 pandemic.

The pervasiveness of smartphone engagement among young adults has attracted growing interest regarding its impact on cognitive processes. However, research on the relation between smartphone use and executive function (EF)—a set of adaptive, goal-directed control processes—remains inconclusive due to imprecise estimation of EF dimensions and inconsistent operationalisation of smartphone use in past studies. Therefore, we examined how two indices of smartphone use—screen time and checking frequency—would predict EF (common EF, shifting-specific-, and working-memory-specific components), using a latent-variable approach based on a comprehensive battery of EF tasks. We also examined the moderating role of problematic smartphone use in the link between smartphone use and EF components. We found that screen time positively predicted working-memory-specific and shifting-specific abilities, whereas frequent checking was associated with enhanced shifting-specific, but poorer common EF, abilities. Importantly, problematic smartphone use moderated the relation between checking frequency and common EF. Overall, our findings demonstrate that different indices of smartphone use asymmetrically predict EF facets, thereby highlighting the construct distinctiveness of the various markers of smartphone engagement. Our findings imply that checking frequency and problematic use, rather than screen time, are the most promising targets for interventions that aim to circumvent cognitive impairments by curtailing smartphone use, especially in educational settings.

Screen time for children under 5 is associated with various health risks. Amidst the COVID-19 pandemic, screen use among young children increased significantly. Mothers were more likely than fathers to be the primary caregivers and disproportionally assumed the responsibility of monitoring their children's screen time. Several studies have examined children's screen use throughout the pandemic; however, few have addressed mothers' experiences. Therefore, the current study aimed to investigate mothers' perceptions regarding the barriers and facilitators faced when trying to reduce their child's pandemic screen time, as expressed on Reddit (a social media platform for anonymous discussion and information sharing). Two subreddit forums targeted toward mothers, "mommit" and "beyondthebump," with 646,000 and 554,000 users, respectively, were examined. Posts were collected using related search terms and screened for inclusion by three independent researchers. Inductive thematic content analysis was leveraged to identify themes. In total, 582 posts were reviewed from March 14th, 2020, to August 31st, 2022. Qualitative analysis yielded 5 themes; 6 barriers and 2 facilitators were derived from themes and/or subthemes, where applicable. Results suggest that mothers faced barriers when trying to reduce their child's screen time, including their competing work and in-home obligations, using screens to occupy their child during travel, child screen use with other caregivers, offering their child screen time while they needed rest, pandemic changes in routine, and using screens to encourage their child to engage in necessary behaviours. However, facilitating factors, including advice received from other mothers on how to reduce their child's screen time and the sharing of non-screen alternatives supported mothers in lowering their children's screen time. These results are important for future interventions, which may utilize the conclusions of this study to address what mothers perceive to be helping or hindering them, thus empowering mothers to successfully limit their children's screen time.

Studies suggest excessive screen time (use of smartphones, televisions, computers and/or video games) is linked to speech and language delay. This study explored the sociodemographic characteristics of children with speech delay in Kuantan, Malaysia, and the association of screen time with speech and other developmental delays. This cross-sectional study was conducted between July and November 2019 at the child psychiatry and speech therapy clinics, at Kuantan Hospital, Pahang, Malaysia. Parents of children with speech delay aged <72 months provided information on their children's and their own screen times. Speech and other developmental skills were assessed using the Schedule of Growing Skills II with scores reported as developmental quotient (DQ) level. The study included 91 children (67 boys, 24 girls) of whom 54.9% had primary speech delay and 45.1% had neurodevelopmental disorders; their mean age was 39.9 ± 11.52 months. The children's mean screen time was 2.26 ± 1.98 h daily, with 36.3% exceeding 2 h. Higher children's screen time was moderately correlated with higher parental screen time (rs = 0.479, P < 0.01). Household income was positively correlated with screen times of the children and the parents (rs = 0.243, P = 0.02 and rs = 0.390, p < 0.01, respectively). Parents who intended to reduce their children's screen time reported higher screen time in their children (t(89) = 2.322, P = 0.023). Children's age was positively correlated with the number of types of screen media (rs = 0.225, P = 0.032). The mean speech DQ was 54.76 ± 24.06%. Lower speech DQ was associated with lower DQs in other skills (P < 0.01). No significant correlation was shown between children's and parents' screen time with DQs of speech and other skills (P > 0.05). The correlation between parent and child screen time provides an opportunity for possible intervention, where necessary. Larger studies are required to examine this correlation further.

Excessive screen time in children is a growing concern for parents and healthcare providers worldwide because it frequently leads to behavioral problems. Although executive dysfunction is proposed to be one of the contributing factors to maladaptive behaviors, little is known about the link between screen time and behaviors. This study aimed to identify whether executive dysfunction contributes to the negative behaviors of children exposed to excessive screen time. A cross-sectional study was conducted on preschool-aged children from public and private schools in Chiang Mai, Thailand. The parents/guardians of each child completed the questionnaires regarding clinical characteristics and screen time use, the Behavior Rating Inventory for Executive Function-Preschool (BRIEF-P), and the Strengths and Difficulties Questionnaire (SDQ). Children with more than one hour of media exposure per day were considered to have excessive screen time. Multivariable Gaussian regression was analyzed to compare the BRIEF-P and SDQ scores between the excessive and appropriate screen time groups. Causal mediation analysis was performed to examine the effects of total screen time on increasing behavioral problems with executive functioning as a mediator. A total of 1,126 preschoolers were included in the analyses. After controlling for age, sex, socioeconomic status, and maternal education, the excessive screen time group had significantly higher BRIEF-P global executive composite score than the appropriate screen time group (mean difference of global executive composite score = 1.49, 95% CI [0.12, 2.86], and p = 0.033). Concurrently, there were significant differences in externalizing behavior subscales and SDQ total difficulties scores between the excessive and appropriate screen time groups (mean difference of total difficulties score = 0.90, 95% CI [0.29, 1.50], and p = 0.004). A significant average causal mediation effect (ACME) of screen time on behavioral problems mediated through executive functioning was β = 0.28, 95% CI [0.13-0.44], which was more than half of the total effect (54.9%, 95% CI [37.4-100%]). The current study suggests that the increase in behavioral issues in preschoolers might be partly explained by the direct effect of excessive screen time and the mediating effect of impaired executive functioning. Our results may raise concerns about the necessity to limit screen time and monitor for executive function deficits and behavioral problems in young children with high screen time.

School's out: Parenting stress and screen time use in school-age children during the COVID-19 pandemic

Excessive screen time in young children is a growing concern in the digital age. It is important to explore parental beliefs and practices that could shape children's screen time routines. This cross-sectional study surveyed 3624 parents of children aged 2-5 years from five northern Indian states between July and October 2024. The participants completed a validated questionnaire assessing sociodemographic factors, children's screen time duration, parental beliefs and practices related to screen time regulation (guidelines and enforcement), screen use purposes (eg, feeding, chores) and perceived impacts on child development (eg, social skills, attention, speech/language). Data analysis included χ2 tests and multinomial logistic regression to identify associations between variables. Over 60% of the children spent 2-4 hours daily on screens, with no significant associations between weekday-weekend screen time patterns and sociodemographic factors. Multinomial logistic regression revealed that the odds of excessive screen use were greater among children whose parents were unsure of whether restrictions should be set (AOR=3.03 for 4-6 hours), those whose parents did not set screen time limits (AOR=1.64 for 4-6 hours and AOR=2.07 for >8 hours), those whose parents used screens during feeding (AOR=1.82 for 2-4 hours; AOR=2.66 for 4-6 hours, AOR=2.79 for 4-8 hours and 3.54 for >8 hours) and those whose parents did not believe that screen time hindered speech and language development (AOR=1.77 for 2-4 hours and AOR=2.11 for 4-6 hours). Parental factors, including the absence of screen time limits and the cultural use of screens during mealtimes, contribute to excessive screen time. Interventions in India should focus on practical programmes that support parents in managing screen time, tailored to regional and cultural contexts.

Cross-cultural research can provide insight into whether levels and correlates of movement behaviours among early years children vary across different cultural contexts. This study (1) compared children's physical activity (PA) and screen time (ST) and parental and environmental correlates of PA and ST between samples of Canadian and South Korean (Korean thereafter) early years children (2-5 years) and (2) investigated parental and environmental correlates of PA and ST and whether country moderates the relationships. Cross-sectional data from 121 Canadian children (3.4 years; 49.6% girls) and 101 Korean children (3.4 years; 54.9% girls) who participated in the Parents' Role in Establishing healthy Physical activity and Sedentary behaviour habits (PREPS) study were used. Demographic information, children's PA, ST, PA- or ST-specific parental cognitions and behaviours, and home and neighbourhood environments were measured using a proxy-reported questionnaire. Two-tailed independent samples T test or Mann Whitney U test, chi-square tests, linear regression and moderation analyses were performed. Canadian children spent more time in non-organized PA compared to Korean children (111 vs. 63 min/day), whereas time spent in organized PA was higher in Korean children than Canadian children (25 vs. 9 min/day). Canadian children had more ST than Korean children (159 vs. 110 min/day). Similarly, Canadian parents reported higher screen (142 vs. 116 min/day) and sitting time (317 vs. 286 min/day) than Korean parents. Though children's behaviours, as well as parental cognitions and behaviours, varied between the two samples, similar correlates of children's PA and ST were observed. The relationship between presence of electronics in children's bedrooms and children's ST was moderated by country, with Canadian children showing a stronger relationship than Korean children. Supporting parents to adopt cognitions and behaviours that are conducive to healthy PA and ST patterns of their own and their early years children may be important for both Canada and Korea.

This study aims to investigate if maternal influences are associated with children's outdoor playtime and screen time at the age of 2 years. A cross-sectional study with 497 first-time mothers and their children was conducted using the data from the Healthy Beginnings Trial undertaken in Sydney, Australia during 2007-2010. Maternal influences included their own physical activity and screen time, television rules for their child, perceived neighbourhood environment, parental self-efficacy and parenting style (warmth and hostility). Children's outdoor playtime, screen time and maternal influences were collected through face-to-face interviews with participating mothers when the children were 2 years old. Logistic regression analysis was conducted to examine the associations between maternal influences and children's outdoor play and screen time. Mothers with low levels of parental hostility and high perceived safe outdoor play environment were more likely to have children playing outdoor for ≥ 2 h/day with adjusted odds ratio (AOR) 2.65 (95% confidence interval (CI) 1.68-4.20, P < 0.0001) and AOR 2.44 (95% CI 1.85-3.85, P < 0.0001) respectively. Mothers' own screen time was the sole factor associated with children's screen time (AOR 1.90 (95% CI 1.29-2.81, P = 0.001)). Different maternal influences were independently associated with children's outdoor play or screen time at an early stage of life. Therefore, different intervention strategies are needed to increase children's outdoor playtime and decrease their screen time.

Experienced 3 years of pandemic-induced home life, in the post-epidemic period, preschoolers in China are falling short of the World Health Organization's standards for screen time and outdoor activities. This notably impacts their physical well-being. The study aims to probe the associations between screen time, outdoor activities, and the physical health of preschoolers, offering insights to shape interventions targeting myopia and obesity prevention in children. A cross-sectional study was conducted in Guangdong Province, involving a representative sample of 23,992 preschoolers and their caregivers recruited through proportional stratified cluster sampling. Data collection utilized the Chinese Early Human Capability Index (CHeHCI, eHCi), a questionnaire on children's media use in daily family life, and Body Mass Index (BMI). Linear regression and binary logistic regression models were employed to analyze the impact of screen time and outdoor activity duration on the physical health of preschoolers. In the high family socioeconomic status (SES) group, children had significantly less screen time compared to those in the medium and low SES groups. Outdoor activity time varied significantly based on SES, with higher SES linked to extended outdoor engagement. Additionally, children's eHCi health dimension score exhibited significant SES-related differences, showcasing higher scores for children in higher SES groups. In terms of gender differences, boys dedicated significantly more time to outdoor activities than girls, yet boys had a notably higher overweight rate. Furthermore, girls demonstrated better health outcomes based on eHCi health scores. A significant association emerged between overweight and screen time in children with high SES, indicating that prolonged screen time was linked to a higher likelihood of overweight based on BMI. Additionally, a substantial negative correlation was observed between children's eHCi health dimension score and screen time. Furthermore, children's outdoor activity time exhibited a significant positive correlation with eHCi health dimension score. Regression analysis revealed that screen time could significantly negatively predict children's physical health score, while outdoor activity time could significantly positively predict children's eHCi physical health score. The current study highlights that family SES, age, and gender play pivotal roles in influencing preschoolers' screen time and outdoor activity duration, with family SES being particularly influential. Higher family SES correlates with reduced screen time, increased outdoor activity, and elevated health levels among children. Importantly, children's screen time negatively predicts their health status, while outdoor time positively predicts their health status.

BackgroundSocioeconomic status (SES) is an important determinant of screen time (ST) in children and adolescents, however, the association between SES and ST is not fully understood in China. This study aimed to investigate the association between SES and ST (operationalized as meeting the ST guidelines; no more than 2 hours per day) in Chinese children and adolescents.MethodsCross-sectional data of 2,955 Chinese children and adolescents aged 8 to 17(53.4% girls) were used. SES was measured using indicators of parental education and perceived family wealth. ST was assessed with detailed items from the Health Behaviour School-aged Children survey questionnaires. Descriptive statistics and a Chi-square test were used to report the sample characteristics and analyse ST differences across different sociodemographic groups. A binary logistic regression was then applied to analyse the association of SES indicators with ST in children and adolescents.ResultsOverall, 25.3% of children and adolescents met the ST guidelines. Children and adolescents with higher parental education levels were 1.84 [95% CI 1.31–2.57; father] and 1.42 [95% CI 1.02–1.98; mother] times more likely to meet the ST guidelines than those with lower parental education levels. Associations between SES and ST varied across sex and grade groups. Moreover, the associations of SES with ST on weekdays and weekends were different.ConclusionsThis study demonstrated the association between SES and ST in children and adolescents, highlighting the importance of targeting children and adolescents with low SES levels as an intervention priority. Based on our findings, specific interventions can be tailored to effectively reduce ST. Future studies are encouraged to use longitudinal or interventional designs to further determine the association between SES and ST.

BackgroundNumerous cardio-metabolic risk factors influence screen-related behaviors in children and adolescents. Numerous studies with inconsistent results revealed a relationship between blood pressure and screen time in the children and adolescents. This systematic review and meta-analysis summarized the data regarding the relationship between screen time and hypertension (HTN) in children and adolescents.MethodsWe examined three electronic databases, including Scopus, PubMed, and Embase to find the recent research on the relationship between screen time and HTN up to 19 July 2022. Twenty papers were included in the final two-class and dose–response meta-analysis. We conducted subgrouping to identify the source of heterogeneity.ResultsThe highest category of screen time increased the odds of HTN by 8% [odds ratio (OR): 1.15; 95% confidence interval (CI): 1.08, 1.23; P < 0.001; I2 = 83.20%] and 1.9 mmHg increase in systolic blood pressure [weighted mean difference (WMD): 1.89; 95% CI: 0.18–3.62; P = 0.030; I2 = 83.4]. However, there was no significant difference in diastolic blood pressure. Moreover, screen time in hypertensive children and adolescents was 0.79 h (47.4 min) higher than normotensive subjects (WMD: 0.79; 95% CI: 0.02, 1.56; P = 0.046; I2 = 92.8). A departure from linearity was observed between increased screen time [digital video discs, personal computers, and video games and HTN (Pnonlinearity = 0.049).ConclusionThis systematic meta-analysis review is the first to demonstrate a positive correlation between screen time and HTN in children and adolescents.